Individual
JACOB MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1745 QUENTIN RD, LEBANON, PA 17042-7435
(717) 274-6779
Mailing address
1745 QUENTIN RD, LEBANON, PA 17042-7435
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP448821
PA
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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